Materializing research promises: opportunities, priorities and conflicts in translational medicine

Abstract

There is considerable evidence that the translation rate of major basic science promises to clinical applications has been inefficient and disappointing. The deficiencies of translational science have often been proposed as an explanation for this failure. An alternative explanation is that until recently basic science advances have made oversimplified assumptions that have not matched the true etiological complexity of most common diseases; while clinical science has suffered from poor research practices, overt biases and conflicts of interest. The advent of molecular medicine and the recasting of clinical science along the principles of evidence-based medicine provide a better environment where translational research may now materialize its goals. At the same time, priority issues need to be addressed in order to exploit the new opportunities. Translational research should focus on diseases with global impact, if true progress is to be made against human suffering. The health outcomes of interest for translational efforts need to be carefully defined and a balance must be struck between the subjective needs of healthcare consumers and objective health outcomes. Development of more simple, practical and safer interventions may be as important a target for translational research as the development of cures for diseases where no effective interventions are available at all. Moreover, while the role of the industry is catalytic in translating research advances to licensed interventions, academic independence needs to be sustained and strengthened at a global level. Conflicts of interest may stifle translational research efforts internationally. The profit motive is unlikely to be sufficient alone to advance biomedical research towards genuine progress.

The Role of Blood-Brain Barrier Studies in the Pharmaceutical Industry

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“…Inadequate access to non-academic experts in these areas poses a challenge to the success of the translational process. Thus, even in the early stages of translation, there is a need for better interactions between investigators and individuals associated with the commercial side of translation; in fact, one of the best predictors of success in the clinical development of a promising idea is the early involvement of industry 33 . All stakeholders will therefore benefit from defining ways to encourage such interactions as early as possible in the translation process.…”

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